Background:
Most men infected with C. trachomatis [CT] and/or N. gonorrhoeae [GC] are asymptomatic. Urine samples can be inaccurate as the first void may be lost or diluted during collection Men might agree to screening if swab self-collection was easy to perform.

Objective:
To determine [a] whether men can collect their own urethral swab; [b] the accuracy for detecting the presence of CT and GC in the sample by an APTIMA Combo 2 assay.

Method:
A total of 293 men [15-25 years of age] attending a youth street clinic or STD clinic consented to collect a first void urine [FVU] and their own urethral swab [US]. Each was instructed to pull back on the penis shaft and to insert the tip of the cotton swab 1-2 mm into the opening, to turn the swab once, then to place it into the bottom of the collection tube, before breaking the swab shaft and capping the tube. Order of collection of the FVU and US was randomized. The samples were tested for CT and GC in the APTIMA Combo 2 assay [GenProbe].

Result:
Prevalence of infection was 6.8% [20/293] for CT and 4.4% [13/293] for GC. Three men were infected with CT and GC. The self-collected swab identified 19 [95%] CT and 13 [100%] GC infections. Eighty percent of the men were asymptomatic and 92% were not circumcised. Neither factors were statistically associated with infection. All men said that the self-collection was easy to do.

Conclusion:
A self-collected urethral swab tested by the APTIMA Combo 2 assay could serve as a minimally invasive specimen to screen asymptomatic men for CT and GC.

Implications:
Provides an alternative self-collected specimen for screening asymptomatic men for CT and GC; eliminating the concern that a urine submitted is not the first 10-20 ml of a void.